Individual provider Active NPI

Suzette Nicole Boyd, APN

  • Family Nurse Practitioner
  • De Witt, AR
National Provider Identifier
1710207808
Registry record updated Jun 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A03371 Issued in AR
Practice address
1641 South Whitehead Drive
Dewitt, AR 72042-0000
Phone
(870) 946-3637
Fax
(870) 946-4409
NPI assigned
Jun 11, 2010
Last updated
Jun 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A03371 AR Primary

Addresses

Primary practice location

1641 South Whitehead Drive
Dewitt, AR 72042-0000

Mailing address

P O Box 512
Dewitt, AR 72042-0512
Phone (870) 946-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000459 AR Practitioner - Nurse Practitioner 9234221730 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
A03371ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Oct 1, 2015 Accepting new patients
Southeast Arkansas Emergency Physicians LLP CurrentSince Oct 1, 2015 Accepting new patients
Dewitt Hospital & Nursing Home, Inc. Past Accepting new patients

Locations

1600 W 40th Ave
Pine Bluff, AR 71603
Phone (870) 541-7100

Interoperability endpoints

  • Direct secure messaging: suzette.boyd.1@14940.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276214400000",
    "number": "1710207808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 512",
            "city": "DEWITT",
            "state": "AR",
            "postal_code": "720420512",
            "telephone_number": "870-946-3637",
            "fax_number": "870-946-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 SOUTH WHITEHEAD DRIVE",
            "city": "DEWITT",
            "state": "AR",
            "postal_code": "720420000",
            "telephone_number": "870-946-3637",
            "fax_number": "870-946-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "SUZETTE",
        "middle_name": "NICOLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-11",
        "last_updated": "2010-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Witt, AR

Sources for this page

Verify at the official NPI Registry.